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The Risks of Eating Out

The April 2007 issue of Annals of Allergy, Asthma and Immunology contains an important study authored by Ryan Ahuja and Scott H. Sicherer MD on the risks of eating out for people with food allergies. According to the study, restaurant cooks and staff are growing increasingly confident in their ability to prepare and serve safe meals to patrons with food allergies, but their knowledge of how to prepare and serve allergen-free foods is often lacking.

This dangerous combination of confidence and ignorance can result in a very risky situation, and this study reminds all of us with food allergies to be particularly vigilant when dining out.

Here are some tips for choosing a food-allergy-friendly eatery:

Avoid the riskiest restaurants:

Buffets: With all those foods sitting so close to one another, there’s just too much risk for accidental exposure or cross-contamination.

Bakeries: In addition to the risk of airborne allergens, particularly for people with wheat allergy, bakeries are notorious for cross-contamination.

Restaurants that serve pre-made foods: Some restaurants get pre-made entrees that they slap together to create your meal. The cook may not even know what ingredients a particular menu item contains.

Restaurants that serve more of what ails you: If you have a peanut allergy, you may want to steer clear of restaurants that typically add peanut to many of their dishes, particularly Asian restaurants. If you’re allergic to fish or shellfish, seafood restaurants are obviously off your list. Milk allergy? Don’t stop at the local ice-cream shop for dessert.

Opt for safer restaurants, such as:

Fast-food and franchise restaurants: These restaurants usually have standard food preparation and cooking procedures in place, they often share less equipment, and most have Web sites where your can study the ingredients in detail before your visit.

Restaurants with a cooperative & informed staff: Ideally, when you inquire about allergen-free foods, the server, cook, and manager should be receptive, knowledgeable, caring, and sensitive. Many of the restaurants that fit this description are run by managers who have food allergies or have a close family member with food allergies. If the staff seems uncaring, cross the restaurant off your list.

Steak houses: Your local steak or beef house may be one of the best places to avoid allergens. These meat-and-potato restaurants commonly serve up pure beef along with potatoes and salads. You still need to be careful about the chef’s secret sauce or barbecue rub and the salad dressings and other items, but a brief conversation with the cook can help you work around these minor complications.

Ask before you eat

“Ask Before You Eat” is the advice that New Jersey’s Department of Health and Senior Services (NJDHSS) and researchers at Rutgers University’s Food Policy Institute and Department of Nutritional Sciences offer to people with food allergies.

That simple bit of advice is your best protection against accidental exposures and cross-contamination. Unless the restaurant staff is fully aware of your food allergies and is well informed on how to properly prepare food to prevent cross contamination, you can’t really expect them to serve you a safe meal.

If you own or work in a restaurant or the owner of your favorite eatery wants to learn more about allergy-free cooking, the Food Allergy and Anaphylaxis Network, the Food Allergy Initiative, and the National Restaurant Association have worked together to develop an excellent education program called Food Allergy Training Guide for Restaurants and Food Services. You can order it online or call the Food Allergy and Anaphylaxis Network at 800-929-4040. I believe that the rising prevalence of food allergies along with programs such as these and the growing willingness of restaurants to cooperate will lead to restaurants with increased allergy awareness where those with food allergies can dine more safely.

Remember: Regardless of how safe you feel at a particular restaurant, never leave home without your emergency medications, and wear your medical ID bracelet or necklace at all times.